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Epub 2016 Oct 31

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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy)

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meanwhile, advancing age itself brings declines in natural fertility and increased risks of chromosomal abnormalities and pregnancy complications ( 1.2 Central role of obesity and IR in PCOS infertility Against the backdrop of the obesity epidemic and the trend of delayed childbearing, the predominantly obese PCOS phenotype presents compounding challenges to female fertility